| NPI | 1467690883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 105449) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-01867) |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2009-01-22 |